Provider Demographics
NPI:1083801401
Name:MERK, CHRISTINA C (PT)
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:C
Last Name:MERK
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 417
Mailing Address - Street 2:
Mailing Address - City:FLOYDS KNOBS
Mailing Address - State:IN
Mailing Address - Zip Code:47119-0417
Mailing Address - Country:US
Mailing Address - Phone:502-608-8475
Mailing Address - Fax:
Practice Address - Street 1:727 MOUNT TABOR RD
Practice Address - Street 2:SUITE D
Practice Address - City:NEW ALBANY
Practice Address - State:IN
Practice Address - Zip Code:47150-6951
Practice Address - Country:US
Practice Address - Phone:812-945-2453
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-09-30
Last Update Date:2007-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY001184225100000X
IN05002026A225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN2008849950Medicaid
000000283358OtherANTHEM